Low Adiponectin Levels Are an Independent Predictor of Mixed and Non-Calcified Coronary Atherosclerotic Plaques

Abstract

BackgroundAtherosclerosis is the primary cause of coronary artery disease (CAD). There is increasing recognition that lesion composition rather than size determines the acute complications of atherosclerotic disease. Low serum adiponectin levels were reported to be associated with coronary artery disease and future incidence of acute coronary syndrome (ACS). The impact of adiponectin on lesion composition still remains to be determined.Methodology/Principal FindingsWe measured serum adiponectin levels in 303 patients with stable typical or atypical chest pain, who underwent dual-source multi-slice CT-angiography to exclude coronary artery stenosis. Atherosclerotic plaques were classified as calcified, mixed or non-calcified. In bivariate analysis adiponectin levels were inversely correlated with total coronary plaque burden (r = −0.21, p = 0.0004), mixed (r = −0.20, p = 0.0007) and non-calcified plaques (r = −0.18, p = 0.003). No correlation was seen with calcified plaques (r = −0.05, p = 0.39). In a fully adjusted multivariate model adiponectin levels remained predictive of total plaque burden (estimate: −0.036, 95%CI: −0.052 to −0.020, p<0.0001), mixed (estimate: −0.087, 95%CI: −0.132 to −0.042, p = 0.0001) and non-calcified plaques (estimate: −0.076, 95%CI: −0.115 to −0.038, p = 0.0001). Adiponectin levels were not associated with calcified plaques (estimate: −0.021, 95% CI: −0.043 to −0.001, p = 0.06). Since the majority of coronary plaques was calcified, adiponectin levels account for only 3% of the variability in total plaque number. In contrast, adiponectin accounts for approximately 20% of the variability in mixed and non-calcified plaque burden.Conclusions/SignificanceAdiponectin levels predict mixed and non-calcified coronary atherosclerotic plaque burden. Low adiponectin levels may contribute to coronary plaque vulnerability and may thus play a role in the pathophysiology of ACS.

Atherosclerotic Calcification: Wnt Is the Hint

“…In addition, there are suggestions that an obstructive calcified lesion is more stable than a nonobstructive thin‐cap fibroatheroma, because the calcified plaque leads to stable angina pectoris, whereas the fibroatheroma has a tendency to rupture 36. Thus, calcification may be paradoxically beneficial, despite its associations with cardiovascular morbidity and mortality 30.…”

Chemerin is associated with markers of inflammation and components of the metabolic syndrome but does not predict coronary atherosclerosis

“…A total of 303 consecutive (relating to the order in which they attended the clinic) patients who underwent DSCT-coronary angiography for exclusion of coronary artery stenosis due to stable typical or atypical chest pain were recruited during 20 consecutive months from March 2006 to October 2007 as previously described (11). All patients were of Caucasian origin.…”

“…The study protocol was approved by the Ethics Committee of the LudwigMaximilians-University Munich, Germany. Baseline characteristics of the study cohort (Table 1) have in part been previously reported (11).…”

“…Dual-source multi-slice CT-coronary angiography CT-coronary angiography and image analyses were performed as previously described (11,12). Briefly, for the analysis of coronary plaque morphology, all reconstructed data sets were evaluated at different ECG-phases for diagnostic image quality and the optimal data set was then chosen.…”

“…PAT volume was measured in milliliters using the volume analysis software tool of the Siemens Leonardo Circulation workstation. PAT volume was determined as previously described (11,12). We defined PAT as the adipose tissue surrounding the myocardium.…”